Nina Spears is the Co-Founder & CEO of Baby Chick, an online go-to resource for all things motherhood and the Founder & CEO of Bassett Baby Planning, the premier doula agency and resource center in Houston, TX for expecting and new mothers. Read More

Your baby’s due date is quickly approaching and you are probably now beginning to feel how real everything is. This is happening. YOU are going to have a baby. That means this baby has to come out. If you have started your research on birth and have maybe watched some Youtube videos on vaginal births and C-sections (which, be prepared if you do watch the videos), you may begin to realize that having a cesarean birth really isn’t something that you want to happen unless it’s absolutely medically necessary. Although, I do want to say, thank goodness for cesarean births because they have saved thousands of womens’ and babies’ lives. However, it isn’t something that I would want as my first choice for many reasons. If it your first choice to have a C-section, be sure to fully educate yourself on the procedure and the recovery. I want all of our mommy chicks to be well prepared. If a C-section is something that you want to avoid as much as possible, there are some things that you can do to lower your chances of having one. Here are my 11 ways to avoid a c-section:

1. Choose your doctor and hospital carefully.

I feel like many women think that their regular OB/GYN is automatically the person that should deliver their baby. This is absolutely not true. I know that you probably have a great relationship with your doctor, otherwise you wouldn’t be going to him/her, but you need to ask some tough questions to see if he/she is going to be able to support you with the birth experience that you want. You only get one time to do this with your baby. And this experience can affect your future pregnancies and births. If your doctor isn’t giving you the answers you want to hear or is stalling with their answers, I recommend that you start looking for another doctor.

Be sure to ask your doctor what his/her C-section rate is so you know how often they perform them. This can give you an idea if a C-section is in your future. The national average of cesarean births is 33% (which is still a high number – that’s one out of three women), but I have heard of doctors having even higher averages than that. Horrible! You also want to ask what his/her practice’s/call group’s C-section rate is. Your doctor might not even be the person at your birth, which happens a lot of the time, so make sure that you have an understanding on how the on-call doctors practice, what their C-section rate is, and what their philosophy is on birth.

Another question to ask is which hospitals they have privileges at. If you start asking people in the community (which I highly recommend asking doulas in your area since they have been to probably the majority, if not all, of the hospitals), you will quickly learn which hospitals you want to avoid. Some hospitals have better reputations than others and I will say, having a positive atmosphere and support team of care providers helps tremendously with the outcome of your birth.

2. Or choose a midwife and birth center.

Some people think that having a midwife might be weird or even scary, which is unfortunate. It really is a safe and wonderful option. Midwives truly believe in your body and it’s ability to give birth. They are not waiting for a disaster to happen like some doctors are. Midwives also have a much lower C-section rate than OBs – ranging around 3 to 4%. Unfortunately, doctors are a lot quicker to recommend a C-section even when it’s not necessary. Midwives don’t think C-sections are necessary as often as doctors do, but will call for one if truly needed.

If you do not feel comfortable having a homebirth, you can choose to give birth at a birth center. Your environment there will be calm and peaceful as well. No matter where you choose, you can feel safe that your midwife will have all of the tools and medications to keep you and your baby safe. Talk to your local midwives and visit your local birth centers to learn more about these options.

3. Communicate with your care provider.

Whether you decide to move forward with an OB or a midwife as your care provider, you must communicate and ask questions during your prenatal visits. Let them know what your wishes are. The more that you communicate and talk about what you want, the sooner you will discover how they will assist you and how your birth may go by hearing their replies. I have seen several OBs and midwives practice very differently than what they promised their patient during their prenatal visits. I also recommend keeping a list of questions on your phone or on a piece of paper so that you don’t forget those important questions. Otherwise, pregnancy brain can set in!

4. Hire a Doula.

Studies show that doulas lower the chances of C-sections by 40%. A doula is not a midwife. A doula is someone who is trained and experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth. She’s there to ensure that your birth happens the way that you desire, making suggestions and advocating on your behalf in case you are too distracted or delirious to make these decisions yourself. She can help you determine when the right time is to get an epidural and when/how to change into different positions after you receive it. If you are wanting a natural birth, she can help you with position changes, massage, counter pressure, hydrotherapy, aromatherapy, coaching you and supporting you through each contraction, keeping your partner involved and comfortable, and so much more. A doula can also help you ask the right questions if your OB is suggesting a C-section. Hire a doula!

When I tell women that inductions increase the odds of a cesarean by 40%, they are immediately shocked. I tell my clients that if they are first time mothers, they are doubling their chances of having a C-section if they get induced. That is major! The reason is if the cervix is not ready and your body is not ready, you’re forcing a process to happen that is not ready to begin. Again, if it is medically necessary, this is a good option instead of going straight to a C-section. But unless an induction is medically necessary, try to hold off.

6. Labor at home as long as you can.

Some women start feeling their contractions and immediately get excited and get ready to head to the hospital. The hospital will more than likely send you back home. They’ll ask you to come back when your water breaks and/or once your contractions are five minutes a part, each contraction is lasting one minute long or longer, and that this is a continuous pattern for one hour straight. So stay at home. I promise you will be more comfortable there. At home you can eat, drink, move around any way that you would like, get in the tub, your shower, whatever you want! Once you are in the hospital, you will not have all of the options available to you. Also, the longer you are at the hospital, the more medical interventions could be pushed on you. Interventions can slow down your labor and birth and pave the way for you to have a cesarean. The more interventions that you have, the more likely you will have a C-section. So if you stay at home for the majority of your labor, you will absolutely lower your chances of having a C-section.

7. Have your water break naturally.

I can’t tell you how many times I have seen doctor’s walk into the labor and delivery room to see their patient and after a few minutes of chatting and doing a cervical exam, they say that they are going to break the mom’s water. Aaahhh! Ask why they feel it’s necessary to break your water at this time. The doctor might say that it will help speed up your labor, BUT actually it has been proven that breaking your water is an ineffective way to speed labor. It only causes your contractions to be more painful, it can cause your baby’s heart rate to plummet (which I’ve seen many times) since the water is no longer protecting them and surrounding them and their umbilical cord, and it increases your chances of infection. None of these things are good. Let baby break the water on his/her own. There is no reason anyone should break your water other than if they have an issue finding the baby’s heart rate. I have had some of my clients have their doctors’ break their water if they have stalled out at 8 or 9 centimeters to help them get to pushing, but even that and especially anything sooner is really unnecessary.

And another note, once your water is broken, you must have your baby within 24-hours (sometimes doctors will allow you to go past that) before you have to have a C-section. The reason for this is that they are trying to avoid an infection, chorioamnionitis. So once your water is broken, you are on the clock!

8. Don’t get an epidural too soon.

If you decide to get an epidural too soon, it causes your labor to slow down and potentially stop. Your medical providers will then have to counteract that epidural medication with another medication called Pitocin, which is a synthetic form of oxytocin (the hormone that causes your contractions), which is the drug that they use for inductions. If you get an epidural too soon, even Pitocin sometimes won’t help. You want to make sure that you have established a good labor pattern of effective contractions and are in active labor before you decide to get an epidural. The longer that you wait to get an epidural, the lower your chances are for needing a C-section. Here is when you should get an epidural.

9. Ask for intermittent monitoring.

If you are wanting a drug-free birth, you can request to have intermittent monitoring. If you are going to be induced or have an epidural, you will have to be continuously monitored since they need to see how your baby is reacting to the drugs being given to you. A lot of doctors still want their patients to be continuously monitored even when women are wanting a drug-free birth. However, continuous monitoring prevents women from moving very much during labor, which to me is vital to having a successful natural birth. I mean you can move a few feet from the machine, but that’s about it. This means that women may be unable to change positions freely or use a bath or shower to help with comfort and control during labor. The medical staff can also at times become fixated on constantly getting a perfect reading from the monitor. Mind you, when you move, baby moves so monitors need to be moved with the baby to pick up the heartbeat – this can be quite often. So, unfortunately, rather than focusing on the needs of the laboring woman, they are focusing on getting a constant reading even though baby has been doing well all throughout labor.

NOTE: Some hospitals have wireless and waterproof monitors. So if your doctor demands continuous monitoring, you can still have the option to walk around, move in different positions, and get in the tub with these monitors continuously on you.

As for intermittent monitoring, it is a wonderful option. Your care provider can still check to see how baby is responding to labor, but it allows you to labor the way you want. If you want to move around, get in the water, you can! Also, monitors can be uncomfortable on your belly so to be able to take them off or have them use a Doppler instead is so much nicer!

10. Ask questions during your labor.

If your doctor is recommending a C-section, ask these questions first: 1) Is my baby okay; is there any danger at this point? 2) Am I okay? 3) Can we please wait? If an OB agrees to wait, it shows there is no urgency, just impatience. Sometimes they will say, “Well, we can wait, but things will probably look the same in one to two hours, so why not do the C-section right now?” Yet, if you wait those one to two hours, most likely a C-section can be avoided, and if not, the mother knows she did everything she could and had enough time. You will feel more in control and that’s the key to having a better birth.

11. If you have already had a C-section in the past, find a medical provider and birth location that supports VBACs.

Not all doctors or hospitals will take or allow someone to have a VBAC (vaginal birth after cesarean). If you are wanting to have a VBAC, you want to have a doctor that has a high success rate of VBACs. They obviously will have privileges at a hospital that allows VBACs. So be sure to discuss this with your doctor if you decide to have another baby.

One last thing to keep in mind is that hospitals are in the business of moving things along. They want to get new patients in the beds and have a good turnover so that they can make more money. This is a business for them, you know. So if you’re there and not progressing fast enough for their standards, it’s very likely they’ll make suggestions to speed things up, often to benefit their bottom line, not to the benefit of your child or you. Know that you have options. This is your baby’s birth. You are paying the bills for this birth so you are the boss. Listen to your gut and do what you think is best for you and your baby.